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Some risk factors associated with osteoporosis are out of your control. But you’re in luck, because some can be lessened by following simple tips. Below, Orthopedic Nursing Manager Katie McCarthy discusses the signs, symptoms and preventive measures. By Katie McCarthy, BSN, RN, ONC, Orthopedic Nursing Manager, Renown Health Osteoporosis is often called the silent disease, because it develops gradually for years with no clear signs or symptoms. And while some bone loss is expected as we age, osteoporosis is not a normal part of aging. So it’s important to start thinking about your bone health early.  Bone is not just a lifeless scaffold for the body. It is living tissue that regenerates continually. Once we reach peak bone mass around age 25, we begin losing more bone than we produce, increasing the risk of developing osteoporosis — which literally means porous bone and points to a loss in bone density. In severe cases, normal everyday activities or movements, like hugging, can cause a fracture. After the first fracture you’re at higher risk for more, which can lead to a life of chronic pain and immobility. Bone fractures in the spine or hip are the most serious. Hip fractures can result in disability and even death — especially in older adults. Spinal fractures can even occur without falling. The vertebrae weaken to the point that they simply crumple, which can result in back pain, lost height and a hunched-forward posture.   Osteoporosis: Uncontrollable Risk Factors Women are at greater risk of developing osteoporosis than men, and white and Asian women are at higher risk than black and Hispanic women. Other uncontrollable risk factors include: age; a family history of osteoporosis; certain genetic conditions; medications and medical treatments; eating disorders; a low body weight and small, thin frame; ethnicity; menopause: In fact, the lack of estrogen produced during menopause is largely responsible for a woman’s increased risk. Poor diet, tobacco use, excessive alcohol consumption, lack of exercise and an unhealthy weight also contribute to bone loss. Fortunately, those risk factors are in your control. Without symptoms, you can’t know if you’ve developed osteoporosis unless you get a bone density test or suffer a fracture. If you fall into a high-risk group, are over age 50 or have any concerns about your bone health, consult your doctor and find out if you need to be evaluated. Additionally, if either of your parents sustained hip fractures, you experienced early menopause or took corticosteroids for several months — a steroid often prescribed to relieve inflammation and arthritis — you’ll want to talk to your doctor about your bone health. If you test positive, your doctor will devise a treatment plan to match your needs, which will include lifestyle changes surrounding diet and exercise to build and strengthen weak bones. Medication to slow bone breakdown and build new bone may be prescribed, depending on the severity of your bone loss. If you’ve sustained a spinal fracture that is causing severe pain, deformity or is not responding to non-surgical treatment, your doctor may recommend surgery. Reduce Your Risk of Osteoporosis You can strengthen your bones now to prevent osteoporosis from starting. Here are some tips: Eat a diet rich in fruits and vegetables and low in caffeine, sodium and protein. Avoid soda, and talk to your doctor to make sure you’re getting enough calcium and vitamin D. Don’t smoke — it directly correlates with a decrease in bone mass. Smokers also take longer to heal from a fracture. Limit alcohol to two to three beverages per day. It interferes with the production of vitamins needed to absorb calcium and the hormones that help protect bones. Exercise three to four times each week — it’s key to healthy bones. Weight-bearing exercises like jogging, hiking and especially weight lifting build bone mass and density. There are aspects of the aging process we can’t control, but we can do something about bone loss and osteoporosis. Find out your risk, and show your bones a little TLC — you’re going to need them. This story was also published in the Reno Gazette-Journal’s Health Source on April 24, 2016.

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Experiencing knee pain during exercise or while undertaking daily activities? The knee is the largest joint in our body, so it goes without saying a lot hinges on its functionality. Here are a few exercises to help.   Is exercise a real pain in the knee for you? Does getting up in the morning require a few minutes for your knees to adjust to walking around? As it turns out, knee pain is common, and it can result from injury, overuse or the breakdown of cartilage over time. Often, this pain is a result of faulty mechanics in your body, according to Jessica Ryder, a physical therapist with Renown Physical Therapy and Rehab. “We see weakness at the hips causing a lot of stresses at the knee,” she says. Exercises that Alleviate Knee Pain Try these three exercise to strengthen your glute muscles and maintain proper alignment in your knees. Hip Lift Lie flat on your back with your knees bent and feet flat against the floor. Lift your hips into the air until your body is in a neutral position, then lower your hips back down. Repeat this motion several times until you feel a gentle burn in your glute muscles. Step Down Stand with one foot on a stair or step. Slowly bend your knee and drop the other foot toward the floor. Slowly extend back up to your starting position. While doing this exercise, it’s important to move slowly, maintain control and ensure that your knee is in line with your toes. Do as many reps as needed until you feel a small fatigue in your muscles. Repeat this exercise on the opposite leg. Side Step with Exercise Band Place an exercise band around your ankles. Stand in a slight squat and then take several steps to the side until you feel a small fatigue on the outside of your hips. While doing this exercise, keep your upper body still and focus the exercise to your hips. The band will try to move your knees toward each other Repeat in both directions. Hometown Health and Renown Health are proud to be the official insurance plan and healthcare partners of the Nevada Wolf Pack. Renown Physical Therapy and Rehab | 775-982-5001 Through outpatient physical, occupational and also speech therapy, Renown Physical Therapy and Rehab gives patients hands-on, individualized treatment. Our therapists use evidence-based methods to help patients return to an active, productive lifestyle. Learn More About PT

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When Tabitha Cox received a diagnosis of multiple sclerosis (MS), she was in shock, denial and felt that she was too strong for something like this to be happening to her. As the disease progressed, Tabitha realized she needed to do what she could to stay as healthy as possible. “I heard, ‘You have a quarter-size lesion on your brain,'” recalls Tabitha Cox. “At that moment, that was literally all I heard come out of her mouth.” Tabitha’s official diagnosis was multiple sclerosis (MS), an unpredictable, often disabling disease of the central nervous system that slowly debilitated her mom. “I was numb,” says Tabitha. After her diagnosis, Tabitha went on with her life as if the disease was nothing more than a doctor’s diagnosis. However two years later, Tabitha realized something wasn’t right and sought care at Renown Institute for Neurosciences – Brain and Nerve Care. Her form of MS was aggressive, and her doctor recommended treatment right away.

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An arthritis diagnosis doesn’t mean your exercise routine has to end. In fact, a consistent routine can actually improve mobility. Although stiff and painful joints can make it difficult to keep moving, staying active is essential for easing pain. October 11 is World Arthritis Day, so we asked Michelle Higgins, MPT at Renown Physical Therapy & Rehab some advice about exercising with arthritis. According to the Arthritis Foundation, arthritis affects one in five adults and 300,000 children. As a matter of fact arthritis is the nation’s leading cause of disability. Your joints certainly don’t need to suffer when you exercise. In general exercise is actually necessary for those with arthritis. Not only does it reduce joint pain, but it also increases strength and flexibility. Furthermore those adopting a regular exercise routine also have more energy, deeper sleep and find it easier to maintain a healthy weight. “Exercise is a necessary component to managing your arthritis,” says Higgins. “Consistent participation in an exercise program has been shown to promote long-term pain relief, increased body function and an improved quality of life. Alternatively, a lack of exercise can actually increase joint pain or stiffness and eventually lead to long term disability and suffering.” Exercising With Arthritis Exercise truly is the most effective non-drug arthritis treatment available for reducing pain and improving movement. And it can even include daily activities like gardening, dancing or walking your dog. Of course talk to your doctor or physical therapist about what exercises fit into your specific treatment plan. With this is mind, the four specific components below are important to an effective arthritis exercise program: Range of motion Moving joints through their full available range of movement is important. This frequently increases function and decreases joint stiffness and pain. For this reason, aim to complete these exercises daily. Examples include bending, straightening, and rotating specific joints, or static and dynamic stretching. Strengthening These exercises target muscles supporting and protecting our joints and bones. Strengthening is also necessary for weight control, so two-to-three sessions per week are recommended. In order to allow your body to adapt, begin with light resistance and start slow. Strength exercises include weightlifting and using resistance bands. Low-impact aerobic exercise Aerobic exercise is certainly necessary for overall well-being, weight management and heart health. Aim for two-to-three sessions a week. Low-impact exercises include walking, swimming, cycling, elliptical machine exercises and water aerobics. Balance Good balance is also vital for an effective arthritis program. On the positive side, solid balance prevents falls by increasing your ability to stay upright whether you are moving or sitting still. Likewise, it improves your confidence with walking and daily activities. In order to keep excellent balance, incorporate daily balance exercises. Examples of balance exercises include the use of an exercise ball, Tai Chi and exercises such as standing on one foot. Start Slow, Finish Strong As you begin your exercise program, remember to listen to your body. Start slowly – it can take several weeks for your body to adjust to exercise. Consult your doctor, or physical therapist, if you experience increasing pain or swelling which doesn’t go away with rest. Above all, incorporate fun and motivating activities so you’ll stick to them long term and improve your results. Renown Physical Therapy & Rehab 775-982-5001 Through outpatient physical, occupational and speech therapy, Renown Physical Therapy & Rehab gives you hands-on, individualized treatment in convenient Reno/Sparks locations. We have the latest, most advanced physical therapy and rehab equipment, specialty services and treatments. Renown Physical Therapy & Rehab is now open on Robb Drive in addition to three additional locations in Reno and Sparks. Call 775-982-5001 or visit us online.

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A clubfoot is where the foot is turned in on itself and points toward the ground. A clubfoot diagnosis during pregnancy is surprising and challenging during any circumstance. And in the case of parents anticipating surgery during a pandemic, options can be scarce. These parents took a deep breath, and with the help of Michael J. Elliott, MD, pediatric surgeon with Renown Children’s Hospital, their baby is on the road to recovery.

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Earning its third five-year accreditation, Renown’s neuro-diagnostic lab remains Nevada’s only accredited ABRET facility. The Renown Institute for Neurosciences is pleased to announce that the neuro-diagnostic lab at Renown Regional Medical Center has been re-accredited by the American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET). ABRET’s lab accreditation process evaluates technical standards, the quality of a laboratory’s output, and lab management. “Renown Health is a leader and a destination for health in treating neurological disorders and advancing innovations in neurology. The specialists at the Renown Institute for Neurosciences provide comprehensive brain, nerve and surgical support along with a full range of diagnostic and additional procedures and a disease-specific, patient-focused approach to care,” says Tony Slonim, MD, DrPH, FACHE, President and CEO, Renown Health. “This prestigious honor from ABRET means Renown’s Electroencephalogram (EEG) Laboratory has met strict standards and is recognized as a place where patients and physicians can confidently receive quality diagnostics.” “In addition to re-accreditation from ABRET, the Institute for Neurosciences has earned a Gold Seal of Approval by the Joint Commission and offers advanced treatment options including t-PA (Tissue Plasminogen Activator) and biplane angiography. The Level III accredited Epilepsy laboratory implements some of the newest treatments available,” said Renown’s Chief Medical Officer, Paul Sierzenski, MD, MSHQS, CPE, FACEP. “Renown patients also have access to the most promising new therapies through national clinical trials, which have been shown to significantly improve patients’ health and well-being.” “I am proud to recognize our dedicated team of caregivers for their continued passion and excellence in maintaining the highest standards in patient care,” said Renown Institute for Neurosciences’ Division Chief, Dr. Rolando Ania. “It is all thanks to their tremendous efforts that we remain the only ABRET accredited laboratory, as well as the only nationally accredited epilepsy center (NAEC Level III), in the state of Nevada.” Using a collaborative approach, specialists at the Renown Institute for Neurosciences use leading-edge diagnostic tools to identify neurological conditions and treat patients with the most effective techniques available. What is a Neuro-diagnostic Lab? A neuro-diagnostic lab allows care teams the technology to evaluate how a patient’s peripheral, autonomic, and central nervous systems function, and aid in diagnosing and treating conditions such as epilepsy, multiple sclerosis, Parkinson’s disease, stroke, and other diseases of the nervous system. What is an Electroencephalogram (EEG)? An Electroencephalogram (EEG) is a test that measures and records the electrical activity of the brain. During the test, special sensors called electrodes are attached to the patient’s head and hooked by wires to a computer. The computer then records the brain’s electrical activity on the screen. Using a collaborative approach, specialists at the Renown Institute for Neurosciences use leading-edge diagnostic tools to identify neurological conditions and treat patients with the most effective techniques available. Renown Health hospitals are ranked as Nevada’s top hospitals by U.S. News & World Report.

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It’s true there is no cure for dementia, yet studies suggest your life choices today can reduce brain decline in the future. How important is diet to brain health? Food is the foundation of your body. Fats, carbs and protein provide the energy for your cells and metabolism. So the quality and amount of food you eat directly affects your brain. Specifically, researchers are paying special attention to the link a high sugar diet and/ or an unhealthy fat diet may have on your brain. Your brain on sugar According to the Alzheimer’s Association, when too much sugar is in the bloodstream for long periods of time, it can damage the brain cells. Many people with diabetes may develop brain abnormalities, and these changes may increase chances of dementia — research is still being done to understand this connection. Many U.S. adults have prediabetes with blood sugar higher than normal. Insulin resistance often leads to diabetes. Insulin resistance has been linked to metabolic syndrome, which is a precursor for cardiovascular and cerebrovascular disease (heart attack, stroke). Some signs of metabolic syndrome include: Large waist size (40 inches or more for men, 35 inches and up for women) Low HDL (good) cholesterol level Higher than normal blood pressure — 130/85 and above Current research suggests too much sugar in the blood causes inflammation, which can damage brain cells. High carbohydrate foods, such as sweetened beverages, chips, white rice, white potatoes, bagels, cereals and desserts, have been shown to raise blood sugar. Although anyone can get diabetes, Hispanic Americans and African Americans are at greater risk.

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It’s true that a road trip can change your life, and it did for Sergeant Brandon Ott, just not in the way he was expecting. For nine years, Brandon worked alongside his friend, Denton Tipler, at the police department in Florence, Oregon. To break the monotony of the COVID-19 lockdown, they planned a ‘guy’s trip’ - a pandemic safe, motorcycle adventure traveling through Idaho and Washington. On the morning of July 22, 2020, they set out on their journey. But by 8 p.m., they ran into rough weather - with wind, poor visibility and heavy rain as they rode into Nevada. Four miles from their destination, on a desolate stretch of Highway 140, a gust of wind hit Brandon. Denton watched in disbelief as his friend bounced, tumbled and ultimately came to a stop after sliding over 100 yards. He flagged down the next vehicle, a semi-truck, and the driver did traffic control while another passerby drove to get cell service and call 911.  A Distressing Call  About 10 p.m. the same night, Angie Brog, Brandon’s partner, picked up her phone at the Florence police station. A Nevada highway patrolman let her know Brandon was in a motorcycle accident and had been taken to a hospital in Winnemucca, NV. From there he took a life flight to Renown Regional Medical Center.  Angie immediately called Brandon’s parents and told Addison, their 9-year-old daughter, the news. They quickly packed their bags and drove to Nevada. On the drive to Reno, an ER doctor called Angie to give her Brandon’s status, “I can’t thank him enough. I was so worried. He even gave me his personal cell phone number.”   Upon arrival, she ran to see Brandon in the trauma ICU. “His face was shattered, he had a collapsed lung, a tube was down his throat and something was in his head to relieve pressure from his swelling brain,” she remembers. “He was not expected to live.”  While Brandon was in a coma for three days, Angie was by his side, trying to come to grips with a new normal. “The doctors did not sugarcoat it,” she recalls. “They told me to prepare myself if he pulled through.”  It was a rough week in the ICU with Brandon heavily sedated, so he could heal. From there he was transferred to the neurology floor, where he slowly improved. While there, his daughter Addison got to see him for the first time. Angie says, “When Addison saw her daddy for the very first time, she was relieved, happy she could hug him, and that he was alive.” Miraculously his legs were not broken and he was able to hold simple conversations and walk a few steps.    As the days went on, Brandon’s dad returned to Oregon, and the Inn at Renown became the family’s new home. “It was such a blessing to be so close to Brandon,” Angie observes. “It allowed us to relax a little being in the same building and let us settle in.”  The Comeback Brandon’s first memory after the accident was waking up in the Renown Rehabilitation Hospital, 16 days after his accident, not knowing where he was. (Brandon experienced amnesia due to his brain injury and doesn’t remember the days prior to his rehab stay.) He recalls looking around the hospital room and seeing the photos Angie posted of their family on the walls and wondering, “How did they get pictures of my family?” Immediately after learning that Brandon was awake, Angie raced back to the hospital, went outside his window and talked to Brandon on the phone, reassuring him that they were there for him and everything was going to be ok.  The next morning, he saw Addison for the first time that he remembered since his accident. They each put their hands to the hospital window “touching” each other in an emotional reunion. During the pandemic, each rehab hospital room was designated with an animal, so family and friends could visit outside safely.  Brandon was in the ‘moose’ room. “Whoever thought of that was a genius,” notes Brandon.  A new phase of Brandon’s recovery began at the rehab hospital. "He worked so hard while he was there,” Angie shares. With a minimum of three hours of daily therapy sessions, including speech, occupational and physical therapy. Angie participated in every aspect of his therapy, “I learned so much from the therapists; they included me in everything,” she recalls. “The compassion and patience they have is amazing. It takes a special type of person to do this job. I cannot say enough good things about the Renown Rehabilitation Hospital staff. If he would have been anywhere else, I’m not sure he would be alive,” she says.  It wasn’t easy. Brandon had a brain injury that required a bolt in his skull to relieve the pressure, and a broken left collar bone and left eye socket. His entire face had to be reconstructed. He remembers his face hurting and thinking he looked like Freddy Krueger. When he saw himself in the mirror for the first time, he was surprised to find he only looked thinner, with a gauze pad on his temple.   Prior to the accident, Brandon weighed 300 pounds, but had just finished a year-long fitness journey losing 119 pounds, by doing CrossFit and overhauling his diet. During rehab his weight dropped to 160 pounds and he was known as “the double portion” guy, eating extra food to gain weight.   Shaun Stewart, Therapeutic Recreational Therapist, recalls Brandon riding the recumbent cycle during his recovery. “I remember him saying he didn’t know if he was ever going to be able to ride a bike again and was appreciative when adaptive sports were discussed. He was very willing to participate and excited to be able to get on a bike again. He had a positive attitude and always was willing to get up and get back on the bike.”  Better Together Although Angie and Brandon were in a committed relationship for almost 11 years, they were not legally married at the time of his accident. “In our minds, our lives were perfect,” Angie asserts. “We had lived together for so long and have a child together.” However, because of COVID-19 restrictions, Angie had to lie and tell the medical staff that they were married so she could be by his side. When Brandon woke up from a coma, she told him, “No matter what I’m your wife.” He asked, “What do you mean, you are my wife?” After hearing Angie’s explanation, Brandon said, “Then, let’s do it.”   “We realized when faced with death that the benefits far outweighed the negatives in becoming husband and wife,” Angie discloses. “The rest is history.”  On Tuesday, August 18, 2020, Brandon and Angie were married underneath the trees behind the rehab hospital. Their family, friends and several staff members attended the ceremony. “I think that’s a first for us,” declares Dr. Gavin Williams. “I cleared him for capacity to make decisions, and we had a COVID-friendly wedding on our back lawn before he went back home to Oregon.”  The next day, Brandon officially left the hospital. “I felt good. Like ‘he’s gonna make it,’ but I was also scared,” mentions Angie. The family stayed in town for a couple of days to make sure everything was ok and then traveled home to Oregon.  Not Today Dr. Williams set Brandon’s recovery in the range of six months to two years. Brandon set the six-month mark as his goal and returned to work full time in just under that time. Then, in March 2021, he and Denton completed the David Goggins challenge run -- running 4 miles, every 4 hours for 48 hours. He completed the run with “not today” on the front of his shirt – a new motto.  After the race we wrote a letter of thanks to the Renown Rehabilitation Hospital staff. “I have learned doing ‘hard’ things on purpose is so important. I’ve said this a few times over the past few months after my crash, but I maintain it is the only reason I am still alive. When you do ‘hard’ things, your body (and more importantly your mind) is much better prepared for those unplanned times you face hardships. Maybe even a conversation with death itself, where I somehow had the strength to answer with a firm ‘not today’.”   Brandon describes the rehab hospital as, “A phenomenal facility. Everyone is happy to be there from the doctors, nurses and therapists, to the cleaning staff. Everyone was helpful and nice. They reinforced the positive aspects of my recovery and kept my head in a good spot.”    “Brandon was a great patient and he has made excellent recovery from his brain injury and multiple fractures,” Dr. Williams observes.  Life Goes On These days you can find the Ott family happily spending time with Addison’s new German Shepard puppy Density, camping at Crater Lake for Father’s Day and planning future adventures. Angie reflects, “Life is so precious and tomorrow is never promised.”  Since his crash, Brandon sold all of his motorcycles and now prefers biking on his own power. He even completed a 50-mile ride on July 8, 2021.  “Before this happened, I was on the judgmental side,” Brandon confesses. “This recovery led me to a place of compassion realizing everyone has their own struggles. I’m a much more caring person and am aware how fragile life is. I appreciate life a lot more.”

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Parkinson’s disease – you may have heard of it because Neil Diamond and Ozzy Osbourne were recently diagnosed with it. Or perhaps you know Michael J. Fox is a strong advocate and funds research through his foundation. Neurologist Jonathan Spivack, MD, discusses this disease, while physiatrist Stephanie Jones, DO, explains how physical therapy can help as a supplemental treatment. According to the Parkinson’s Foundation about ten million people worldwide currently have this disease. What is Parkinson’s Disease? “Parkinson’s disease is a neurodegenerative disease that progresses slowly and definitely, though at variable rates,” explains Dr. Spivack. “Symptoms go beyond the classic motor changes. It results from a loss of specific dopamine-producing brain cells. Specifically, this loss is likely due to a mix of genetic and environmental factors,” he adds. Dopamine allows communication between particular nerve cells responsible for movement. If you have Parkinson’s dopamine levels gradually drop, causing a loss of motor skills. Generally, most patients with the disease are over age 65. Early Signs and Symptoms Diagnosing Parkinson’s can be difficult as some of the symptoms happen during the natural aging process. The Parkinson’s Foundation identifies the following 10 early signs of PD: Tremors or shaking of your hand, fingers or chin Small handwriting Loss of smell Sudden movements during sleep Stiffness when walking or moving Constipation Softer or lower voice volume Mad facial expression Feeling dizzy or faint Hunching or stooping posture A single sign may not point to the disease, but if you (or a loved one) has multiple signs, talk to your healthcare provider.

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Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis, answers some common questions about bone fractures. Is there a difference between broken bones and fractures? No, these are two different names for the same injury. Of course the common term is a broken bone. Using either name will describe your concerns. Medical personnel typically describe a broken bone as a fracture to a specific bone. For example, a broken wrist is also a fractured distal radius. To clarify, this describes the injured bone and the precise location. How do I know  if my child has broken their bone? Many times children will fall and complain of their arm or leg hurting. In most cases the pain goes away and the child will return to their activities. When there is a deformity to the limb (curve in arm) and the child is complaining of pain, it is probably a fracture. If the arm or leg looks straight, look to see if there is any swelling or bruising. Both are signs of a possible fracture. Finally, if the limb looks normal but the child continues to complain, gently push on the bone. Likewise if it causes the same pain, then they likely have a fracture and should have an x-ray. My child fractured their growth plate, what does this mean? Growth comes from this area of the bone. In detail, these are located all over the body but typically at the end of the bones. With this in mind, fractures to these areas can result in the bone growing abnormally. Because of potential shortening of the arm or leg, or bones growing crooked, it is important to follow fractures closely (up to 1-2 years or longer). It is better to identify a problem early. Small problems can be treated with small surgeries. What if the bones of the x-ray do not line up? Because children are growing, unlike adults, their bones will remodel and straighten with growth. The amount of remodeling occurring depends on a child’s age, the bone fractured and the location. In many cases an angled bone will grow straight over the course of a year. For this reason, someone with experience in caring for children needs to follow bone growth. How long does it take fractures to heal? Factors deciding when a cast can come off include: Child’s age. Bone fractured. Fracture location. Young children heal faster than teens, teens heal faster than young adults, who heal faster than older adults. In young children most fractures heal in 4-6 weeks. However, teens generally take 6 weeks to heal, and adults can take much longer. Although your child  is out of their cast, it may not be healed completely to return to all activities. Placing a splint is during this time is common. This typically gives them added protection for several weeks after their cast is removed -  in case they forget their limitations. What if my child is still limping? Whether a child is in a walking or non-weight bearing cast, removing it often leaves them stiff and sore. Therefore many children will walk as though they still have a cast in place. In most cases this resolves in about three weeks. Regardless, if your child is still limping or walking abnormally after three weeks, contact the treating doctor. They may benefit from physical therapy or a repeat evaluation.  (This article was original published in the July 2019 issue of South Reno Kids & Sports.)

Read More About Bone Fractures in Children Honest Expert Advice

For Michael J. Elliott, MD, a pediatric orthopedic surgeon specializing in scoliosis, it’s just another day helping patients. But to local five-year-old Makenna Christensen, her substantial spine correction is life-changing. Though her journey to body confidence was months in the making, her smiles are a reminder that a thorough, thoughtful treatment plan can yield amazing results. A Surprising Start Words don’t adequately describe the feelings you have when you unexpectedly learn your child has a birth defect. For Nicole and Nick Christensen it was a shocking surprise. During Nicole’s sonogram appointment something unusual was seen. After an amniocentesis, their baby girl was diagnosed with Noonan syndrome, which can affect a child’s height and bones. To prepare, the couple read all they could on the subject. Fortunately their daughter Makenna, was born full term and healthy. Shortly after birth, Makenna had some feeding issues and returned to the hospital. Although they resolved and she had no major complications, both parents felt unsure about their newborn’s future. With the help of Nevada Early Intervention Services , Makenna’s development was monitored until she was three years old. “Her posture has been an issue her whole life,” says Nicole. Nick also noticed when Makenna started walking her range of motion was poor. It was especially noticeable when she got dressed and raised her arms to put on clothing. Nicole observed Makenna was falling a lot in preschool. She asked Makenna’s pediatrician about physical therapy to support her coordination and muscle tone. Although physical therapy was helping Makenna, her therapist suggested Nicole seek the opinion of Dr. Michael Elliott, a pediatric specialist in orthopedics at Renown Children’s Hospital. Scoliosis Casting - A Successful Treatment Approach Dr. Elliott diagnosed Makenna with scoliosis, an abnormal curvature of the spine. While this condition is most common during a teenage growth spurt, it can also happen in early childhood. Affecting about four million people in the United States, it is estimated 20 percent of all spinal deformities in the U.S. are people living with scoliosis. Makenna’s spinal curve was significant – over 30 degrees. Through years of experience Dr. Elliott opted to put Makenna in a spinal cast, instead of multiple surgeries. “My approach is to postpone surgery as long as possible - it is tough for the patient and families,” he says. “Often excellent results can be achieved through non-invasive treatments such as, casting and bracing.” Nicole appreciated Dr. Elliott’s reassurance through the treatment plan. “It was obvious through the X-rays that there was a significant issue,” she shares. “He guided us through the timing and process and how correcting it sooner would help keep her future growth on track.” For seven months Makenna wore a cast that looked like a tank top, bracing her spine while allowing movement. Now she wears a hard plastic brace, specially fitted to her body.  “Kids tolerate casting well,” explains Dr. Elliott.  “It is a 45-minute procedure. The patient sleeps while their spine is put into traction as the cast dries.” She will continue to wear larger braces as she grows, eventually only wearing them at night. A Straight Path into the Future Dr. Elliott admits, “Not every cast is a cure. Two thirds of a child’s spinal growth happens by the age of five. Getting past the five-year mark means fewer surgeries. It’s wonderful to see Makenna’s body image improved.” Nicole agrees, “The way Makenna holds herself is completely different. She’s more confident on her feet and more balanced.” She can now play with her sister Aria, 4, and brother Lexi, 8 months, without the fear of falling. Nick is in awe of the improvements she has made, “Seeing her thrive more has been wonderful.” The Christensen’s are hopeful about the future. “Makenna is doing really good. She’s wearing her hard brace full time and her growth is consistent,” expresses Nicole. “She’s even starting swim lessons this week.” With mask wearing at every doctor visit during the COVID-19 pandemic, Makenna and Dr. Elliott look forward to seeing each other’s smiles in the future. Makenna’s story highlights the over 18 different specialty options for children locally at Renown Children’s Hospital.

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Stroke is unfortunately common, with 1 in 5 American women experiencing it each year. When it comes to a stroke the phrase “time is brain” speaks to the urgency of getting rapid care. In fact, a woman may lose nearly 2 million neurons per minute of oxygen loss to the brain. The Renown Health Comprehensive Stroke Center experts share the importance of timely treatment and how stroke symptoms can differ in women. Women and Stroke – Surprising Symptoms  Each year stroke affects more women than men. Even more concerning, women are less likely to recover from a stroke. The following non-traditional, less common, warning signs can be common in women: Hiccups with chest pain Sudden disorientation, drowsiness, confusion or a general altered mental status Nausea or vomiting A sudden headache that feels like the ‘worst headache of your life’ Unusual chest pain (especially with hiccups) Body numbness or weakness, such as an arm or leg suddenly ‘falling asleep’ Fainting or loss of consciousness Stroke Diagnosis The first step is neuroimaging by CT scan. This allows for rapid identification of any bleed, and also assists in determining candidacy for the early clot busting medication. MRI brain imaging is much higher resolution, and can better determine the core stroke size, assisting in prognosis and recovery. Since strokes have several different origins, an inpatient workup is essential to determine the underlying cause. Whether the stroke is secondary to plaque in the large vessels, clots being thrown in the setting of atrial fibrillation (an abnormal heart rhythm), or small vessel disease from years of uncontrolled vascular risk factors (high blood pressure, smoking, high cholesterol, diabetes), determining the cause is essential to implementing a management plan to reduce risk for further strokes. Quick Treatment for Stroke is Key Early recognition of stroke symptoms and seeking prompt attention is paramount. There are interventions that can be instituted to minimize the stroke and increase likelihood of recovery, but only if a patient presents to the hospital early. A clot busting medication, called tPA, can be given to patients with stroke if given within 4-5 hours from time of onset. Renown Regional Health Center is designated as a Comprehensive Stroke Center, the highest level of stroke certification available. To earn the designation of comprehensive stroke center, a hospital has to meet stringent requirements, including biannual on-site evaluations. This includes care for ischemic stroke patients (lack of blood flow), hemorrhagic stroke patients (bleeds), and determining the underlying cause to guide secondary stroke management prevention. Stroke Symptoms Remember “B.E.F.A.S.T.” to recognize the symptoms of a stroke below: B – Balance Being off balance or dizzy, is common. E – Eyes An eyesight change such as blurring or double vision may occur. F – Face droop One side of the face, or lip, droops A – Arm weakness Does one arm drift down? S – Speech Talking may slur or sound strange. T – Time Time to call 911. Call an ambulance immediately if you or anyone else, experiences any of these symptoms.

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